Methods and apparatus for performing minimally invasive surgery

Abstract

A device for expanding an elongate opening formed in a skin layer of a patient includes a first arm for engaging one side of the opening and a second arm for engaging the other side of the opening. The device further includes a spreader mechanism, coupled to at least one of the first and second arms, to move the at least one of the first and second arms to widen the opening. The at least one arm is configured to move between a retracted position in which the at least one arm is positioned next to the other arm and an extended position in which the at least one arm is extended to expand the opening. Other embodiments of the device as well as methods for performing a medical procedure are further disclosed.

1 . A method of performing an open heart surgery procedure, the method comprising:
 making a small incision in a skin layer above a breastbone of a patient;   dividing the breastbone to create an opening below the skin layer;   inserting arms of a device into at least one surgically created site, the at least one surgically created site being separate from the small incision;   advancing the arms underneath the skin layer to engage sides of the opening;   expanding the device to increase the opening;   performing a medical procedure;   retracting the device; and   closing the opening.   
     
     
         2 . The method of  claim 1 , wherein expanding the device includes moving at least one arm of the device to widen the opening. 
     
     
         3 . The method of  claim 1 , wherein the device is configured to widen the opening below the skin layer without widening the opening of the skin layer beyond the small incision. 
     
     
         4 . A method of performing surgery, the method comprising:
 making a small incision in a skin layer of a patient;   dividing tissue underneath the skin layer to create an opening;   inserting arms of a device into at least one surgically created site, the at least one surgically created site being separate from the small incision;   advancing the arms underneath the skin layer of the patient to engage sides of the opening;   expanding the device to increase the opening;   performing a medical procedure;   retracting the device; and   closing the opening.   
     
     
         5 . The method of  claim 4 , further comprising retracting the device and closing the opening. 
     
     
         6 . The method of  claim 4 , wherein the device is expanded to spread apart the breastbone up to 20 cm. 
     
     
         7 . The method of  claim 4 , wherein the device is configured to widen the opening below the skin layer without widening an opening of the skin layer beyond the small incision.